Attachment structure

ABSTRACT

A series of appliances including a first shell and a second shell can be designed to incrementally implement a treatment plan. The first and second shells can have cavities designed to receive teeth of a jaw. The first shell can be designed to interface with a first surface of a plurality of surfaces of an attachment structure to provide a first engagement force specific to a first stage of the treatment plan. The second shell can be designed to interface with a second surface of the plurality of surfaces of the attachment structure attached to the at least one tooth of the first jaw to provide a second engagement force specific to a second stage of the treatment plan.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/384,692, filed Apr. 15, 2019, now U.S. Pat. No. 11,382,721, which isa continuation of U.S. patent application Ser. No. 15/645,690, filedJul. 10, 2017, now U.S. Pat. No. 10,258,432, which is a continuation ofU.S. patent application Ser. No. 14/466,734, filed Aug. 22, 2014, nowU.S. Pat. No. 9,700,385, each of which is herein incorporated byreference in its entirety.

FIELD

The present disclosure is related generally to the field of dentaltreatment. More particularly, the present disclosure is related tosystems, methods, computing device readable media, and devices forattachment structures.

Dental treatments may involve, for instance, restorative and/ororthodontic procedures. Restorative procedures may be designed toimplant a dental prosthesis (e.g., a crown, bridge inlay, onlay, veneer,etc.) intraorally in a patient. Orthodontic procedures may includerepositioning misaligned teeth and changing bite configurations forimproved cosmetic appearance and/or dental function. Orthodonticrepositioning can be accomplished, for example, by applying controlledforces to one or more teeth over a period of time.

As an example, orthodontic repositioning may be provided through adental process that uses positioning dental appliances for realigningteeth. Such appliances may utilize a thin shell of light weight and/ortransparent material having resilient properties, referred to as an“aligner,” that generally conforms to a patient's teeth but is slightlyout of alignment with a current tooth configuration.

An example of orthodontic repositioning that can occur through a dentalprocess is a process that uses one or more positioning appliances forrealigning teeth. Placement of an appliance over the teeth can providecontrolled forces in specific locations to gradually move the teeth intoa new configuration. Repetition of this process with successiveappliances in progressive configurations can move the teeth through aseries of intermediate arrangements toward a final desired arrangement.

In some applications, one or more attachments can be used in conjunctionwith the one or more appliances. Attachments are secured to a patient'steeth and interact with a surface of the dental appliance to provide oneor more functions. For example, an attachment can be used as an anchorto hold a portion of the dental appliance in place while other portionsmove one or more teeth. Attachments can also be used to provide a forceto a tooth to move that tooth in a particular direction.

Treatment professionals have access to a number of standard attachmenttypes and these current attachments have one surface that is used toimpart a force to move one or more teeth based on interaction of theattachment's surface and a surface on the dental appliance. In someinstances, a custom attachment can be created for a particular movementand/or a particular patient geometry. Such movements of teeth aretypically associated with a movement prescribed in a treatment plan andare typically selected by a treatment professional based upon thetreatment professional's experience with the type of attachment.

Once selected, the attachment is fixed to the patient's tooth. Theattachment selected by the treatment professional may provide the forcenecessary for one particular stage of the treatment plan.

A different attachment would then need to be placed on the patient'stooth at a different stage of the treatment plan to provide a differentforce. This may result in errors in the placement of the attachments bythe treatment professional, increased cost (e.g., in fabricating andusing multiple attachments and time spent by the patient and treatmentprofessional), and/or increased risk of damage to the tooth in removalof the multiple attachments. Such issues may also result in providingmore, less, or different movement to achieve the desired result than wasinitially predicted by the treatment professional.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates an example view of a portion of a virtual model of ajaw including an attachment structure attached to a virtual toothaccording to one or more embodiments of the present disclosure.

FIG. 2A illustrates an example of an attachment structure according toone or more embodiments of the present disclosure.

FIG. 2B illustrates an example of a plurality of attachment structurecomponents according to one or more embodiments of the presentdisclosure.

FIG. 2C illustrates an example of an attachment structure according toone or more embodiments of the present disclosure.

FIG. 3 illustrates a system for treatment planning according to one ormore embodiments of the present disclosure.

FIG. 4 illustrates an example process for treatment planning accordingto one or more embodiments of the present disclosure.

FIG. 5A-5C illustrate examples of a jaw include an attachment structureattached to a tooth and a series of appliances according to one or moreembodiments of the present disclosure.

DETAILED DESCRIPTION

The present disclosure involves the use of attachments that are attachedto a patient's teeth, to be used to hold a dental appliance onto theteeth of the patient wherein the appliance is utilized to move on ormore teeth by applying force on the one or more teeth or other teeth ofthe patient. Use of the attachments can be used to impart a particularforce on one or more teeth that can be more favorable to a treatmentthan an appliance without the use of an attachment. Attachmentembodiments of the present disclosure each have multiple surfaces thatcan be used in the movement of one or more teeth and these surfaces canbe selectively used individually or in combination to effectuate themovement of the teeth.

For example, in some embodiments, a single surface can be selected froman attachment having five possible surfaces that could be used. In somesuch embodiments, when a successive dental appliance is placed on theattachment, one or more other attachment surfaces can be used inaddition to or instead of the one used previously. As discussed herein,when the surfaces are not used, they may be referred to as inactive andselection and use of a surface may be referred to as activating asurface and that surface is, then active.

In some embodiments, multiple surfaces may be used together toeffectuate the movement of one or more teeth. For example, If a tooth isto be aided in erupting from the gingiva, two surfaces (e.g., onopposite sides of the attachment) can be used to provide a more balancedforce on the tooth than a single attachment surface. Additionally, insuch an embodiment, more force may be applied to one of the two surfacesthereby encouraging the tooth to rotate, for example, if the tooth wasnot erupting in the correct vertical orientation, it may be straightenedthrough use of these attachment surfaces. In another example, multiplesurfaces can be engaged by the appliance to rotate the tooth (e.g., alsoto straighten the tooth vertically, but without erupting the tooth).

A few of the benefits of using such embodiments include, being able toaffix the attachment and then activate different surfaces of theattachment for different phases of a treatment plan rather than havingto affix an attachment and then remove it and replace it potentially foreach successive stage of the treatment plan, and being able to utilizemultiple surfaces to accomplish complex movements that could notpreviously be accomplished, among other benefits.

In contrast to some previous approaches as discussed above, a number ofembodiments of the present disclosure feature a dental positioningappliance (e.g., aligner) interfacing with a multi-faceted attachmentstructure having multiple surfaces that can be activated to interfacewith surfaces on the dental positioning appliance and the structurebeing designed to be attached to a tooth of patient in a treatmentspecific fashion. For example, the attachment structure can include aplurality of surfaces designed to apply a force to the tooth in avariety of orientations to provide a variety of engagement forces. Asdiscussed above, the attachments of the present disclosure can be usedwith a series of dental appliances. In some such embodiments, one,several, or all of a series of appliances can be designed to interfacewith a subset of the plurality of surfaces of the attachment structureto provide one or more engagement forces that are specific to arespective stage of a treatment plan associated with each appliance.

In the following detailed description of the present disclosure,reference is made to the accompanying drawings that form a part hereof,and in which is shown by way of illustration how a number of embodimentsof the disclosure may be practiced. These embodiments are described insufficient detail to enable those of ordinary skill in the art topractice the embodiments of this disclosure, and it is to be understoodthat other embodiments may be utilized and that process and/orstructural changes may be made without departing from the scope of thepresent disclosure. As used herein, “a number of” a particular thing canrefer to one or more of such things (e.g., a number of forces can referto one or more forces).

The figures herein follow a numbering convention in which the firstdigit or digits correspond to the drawing figure number and theremaining digits identify an element or component in the drawing.Similar elements or components between different figures may beidentified by the use of similar digits. For example, 106 may referenceelement “06” in FIG. 1, and a similar element may be referenced as 206in FIG. 2. As will be appreciated, elements shown in the variousembodiments herein can be added, exchanged, and/or eliminated so as toprovide a number of additional embodiments of the present disclosure. Inaddition, as will be appreciated, the proportion and the relative scaleof the elements provided in the figures are intended to illustratecertain embodiments of the present invention, and should not be taken ina limiting sense.

FIG. 1 illustrates an example view of a portion of a virtual model of ajaw 122 including an attachment structure 126 attached to a virtualtooth 124 according to one or more embodiments of the presentdisclosure. The virtual model of the jaw 122 can include a set of teethof the jaw of the patient, including the virtual tooth 124. Theattachment structure 126 can include a virtual model (e.g., a virtualattachment structure) of a physical attachment structure designed to beattached to at least one tooth of a patient.

The attachment structure 126, as illustrated by FIG. 1, can include ageometric shape with a plurality of surfaces 128-1, 128-2, 128-3, 128-4,128-5 . . . 128-N. The attachment structure 126 can be designed to beattached to a tooth of a patient (e.g., the tooth 124). The surfaces128-1 . . . 128-N of the attachment structure, in some embodiments, canbe formed by portions of the attachment structure 126 having a firstheight and portions of the attachment structure 126 having a secondheight, wherein the second height is greater than the first height (asillustrated in FIG. 2A). The surfaces 128-1 . . . 128-N can be the edgesof the portions of the attachment structure 126 having the second height(e.g., the portions of the attachment structure 226 that are raised,also as illustrated in FIG. 2A).

However, embodiments in accordance with the present disclosure are notso limited. For example, in some embodiments, an attachment structurecan include a plurality of attachment structure components (as discussedfurther herein with regard to FIG. 2B). In such embodiments, thesurfaces of the attachment structure can include edges of each of theattachment structure components.

With respect to the example of FIG. 1, one or more appliances can bedesigned to interface with at least one surface of the attachmentstructure 126. For instance, an appliance can be designed to interfacewith a subset of the plurality of surfaces 128-1 . . . 128-N. Theattachment structure 126 can be designed to be attached to the tooth 124of the patient one time and subsequently be used to provide one or moreengagement forces to the tooth 124 without removal or adjustment of theattachment structure. For instance, the surfaces 128-1 . . . 128-N ofthe attachment structure 126 can be oriented about the attachmentstructure 126 such that a variety of combinations of the surfaces 128-1. . . 128-N can provide a variety of engagement forces.

Appliances according to the present disclosure can include, in someembodiments, a plurality of incremental dental position adjustmentappliances. The appliances can be utilized to incrementally implement atreatment plan such as by affecting incremental repositioning ofindividual teeth in the jaw, among other suitable uses. In someimplementations, appliances can be fabricated according to a virtualdental model that has had positions of a number of teeth adjustedaccording to one or more embodiments of the present disclosure.

Appliances can include any positioners, retainers, and/or otherremovable appliances for finishing and maintaining teeth positioning inconnection with a dental treatment. These appliances may be utilized bythe treatment professional in performing a treatment plan. For example,a treatment plan can include the use of a set of appliances, createdaccording to models described herein.

An appliance can, for example, be fabricated from a polymeric shell,and/or formed from other material, having a plurality of cavitiestherein. The cavities can be designed (e.g., shaped) to receive one ormore teeth and/or apply force to reposition one or more teeth of a jawfrom one teeth arrangement to a successive teeth arrangement. The shellmay be designed to fit over a number of, or in many instances all, teethpresent in the upper or lower jaw.

A cavity can be shaped to mate with a particular tooth. For example, aparticular cavity can be shaped to mate with three surfaces of acorresponding tooth to be received therein. The cavity may be slightlyout of alignment with a current configuration of the particular tooth(e.g., to facilitate aligning the particular tooth to a desiredconfiguration), but the cavity can generally conform to the shape of theparticular tooth such that there is not much space between the cavityand the particular tooth when the appliance is worn.

One or more of the surfaces of the attachment structure 126 caninterface with a shell of an appliance to provide a particularengagement force. An engagement force, as used herein, can include aforce on the tooth and/or interference between the one or more surfacesof the attachment structure 126 and the appliance (e.g., the shell) thatproduces a force when the appliance is worn by a patient. Exampleengagement forces can include one or more rotational forces, one or morelinear forces, and/or one or more interferences with the appliance,among other forces.

The cavity shaped to mate with the tooth 124 that the attachmentstructure 126 is designed to be attached to can be slightly out ofalignment with the current configuration of the particular tooth 124 tointerface with the one or more surfaces of the attachment structure 126and to provide the particular engagement force.

For example, an appliance can be designed to fit over teeth in apatient's jaw and the shell can be designed to interface with one ormore surfaces of the attachment structure 126 and/or the teeth of thepatient's jaw. The one or more surfaces that interface with the shellcan be specific to a stage of a treatment plan for which the appliancewas designed. For example, successive appliances created according to atreatment plan may include a shape designed to interface with moreactivated surfaces 128-1 . . . 128-N. The one or more surfaces can beactivated, as discussed further herein, according to a model of a numberof forces used to reposition the at least one virtual tooth 124 adistance according to a stage of the treatment plan. For instance, anactivated surface of an attachment structure, as used herein, isapplying a force and a surface of the attachment structure that is notactivated is not applying a force. Surfaces are activated when adesigner of an appliance selects a surface of the attachment structureto interface with a surface on the appliance to provide a force (e.g.,an engagement force).

An appliance that includes a shape designed to interface with anactivated surface of an attachment structure, as used herein, caninclude a physical appliance with a shape that interfaces with theactivated surface of the attachment structure when the physicalappliance is worn by a patient. The shape designed to interface with anactive surface can include a portion of the appliance, such as a portionof a cavity. Example shapes can include a shape of the cavity and/or aportion of the cavity that is slightly out of alignment with the currentconfiguration of the particular tooth and designed to interface with theactivated surface of the attachment structure. The shape interfacingwith the activated surface can provide the engagement force (e.g., forceon the tooth and/or interference between the surface and the appliancethat produces a force).

The one or more surfaces that interface with the appliance can include asubset of the plurality of surfaces 128-1 . . . 128-N (i.e., less thanall of the surfaces that could be used to interface with an appliance)activated to interface with an appliance of a particular stage of atreatment plan to provide an engagement force to the one or more teeththat is specific to a particular stage of the treatment plan. Forinstance, a treatment plan can include a series of appliances designedto incrementally implement the treatment plan.

A first appliance of the series can comprise a first shell having aplurality of cavities therein designed to receive teeth of a jaw of thepatient. The first shell can be designed to interface with a firstsurface or a first subset of the plurality of surfaces 128-1 . . . 128-Nof the attachment structure 126 to provide a first engagement force (inthe case of a first subset, the first engagement force will be acombination of forces of the subset of surfaces at a selected time inthe stage of the treatment plan) specific to a first stage of thetreatment plan.

The first surface or a first subset of the surfaces 128-1 . . . 128-Ncan be activated (e.g., selected to interface with the shell of theparticular stage of the treatment plan), for instance, based on a modelof a number of forces used to reposition at least one virtual tooth 124a first distance according to the first stage of the treatment plan(e.g., as discussed further herein). For instance, the first shell canbe designed to interface with the first surface or the first subset ofsurfaces 128-1 . . . 128-N to provide the first engagement force to movethe at least one tooth 124 toward a first position that is specific tothe first stage of the treatment plan. Alternatively, the first shellcan be designed to interface with the first surface or the first subsetof surfaces 128-1 . . . 128-N to provide the first engagement force toprevent and/or minimize movement of and/or forces on the at least onetooth 124.

A second appliance of the series can comprise a second shell having aplurality of cavities therein designed to receive teeth of a jaw of thepatient. The second shell can be designed to interface with a secondsurface or a second subset of the plurality of surfaces 128-1 . . .128-N of the attachment structure 126 to provide a second engagementforce specific to a second stage of the treatment plan.

The second surface or second subset of the surfaces 128-1 . . . 128-Ncan be activated, for instance, based on a model of a number of forcesused to reposition the at least one virtual tooth 124 a second distanceaccording to the second stage of the treatment plan (e.g., as discussedfurther herein). For instance, the second shell can be designed tointerface with the second surface or the second subset of the surfaces128-1 . . . 128-N to provide the second engagement force to move the atleast one tooth 124 toward a second position that is specific to thesecond stage of the treatment plan.

Alternatively, the second shell can be designed to interface with thesecond surface or the second subset of surfaces 128-1 . . . 128-N toprovide the second engagement force to prevent and/or minimize movementof and/or forces on the at least one tooth 124. The first engagementforce and the second engagement force can include different forces(e.g., forces specific to the respective stage of the treatment plan).

The first subset and the second subset can, for instance, include atleast one surface that is different between them. That is, the subsetscan include different combinations of the plurality of surfaces 128-1 .. . 128-N. In some embodiments, the first subset and the second subsetcan include at least one common surface between them.

As used herein, a “first stage” does not necessarily mean the originalstage of a treatment plan, but is a relative term with respect to otherstages. For example, the “first stage” may be a second stage of a 25stage treatment plan, while the “second stage” may be a tenth stage ofthe 25 stage treatment plan, with the “third stage”, for example, beinga 15th stage of the 25 stage treatment plan, and the “fourth stage” maybe a 24th stage of the 25 stage treatment plan.

As discussed above, a single attachment structure 126 with a pluralityof surfaces 128-1 . . . 128-N, that can be individually activated in avariety of combinations to provide a variety of engagement forcesspecific to particular stages of treatment, can be advantageous oversome previous approaches that include different attachments fordifferent treatment stages and therefore may require that a treatmentprofessional attach and/or remove attachments at various stages of thetreatment plan. Such additional attachments and/or removal procedurescan lead to additional visits to a treatment professional, increasederror in attachment by the treatment professional, lengthening atreatment plan duration, a need for a revised treatment plan, and/orunnecessary patient discomfort, among other drawbacks.

In contrast, a number of embodiments of the present disclosure allow formore timely, efficient, accurate, and/or comfortable execution oftreatment plans. For instance, the single attachment structure can beattached to a tooth 124 of the patient and the plurality of surfaces128-1 . . . 128-N can be designed to apply a force thereto in a varietyof orientations to provide a variety of engagement forces.

Although not specifically illustrated, in some embodiments, for aparticular stage in a treatment plan, both an upper appliance (anappliance designed to fit over teeth of a patient's upper jaw) and lowerappliance (an appliance designed to fit over teeth of a patient's lowerjaw) can be designed to interface with an attachment structureembodiment of the present disclosure (i.e., attachments fixed to teethon the upper jaw and other attachments fixed to teeth on the lower jaw).A particular stage in a treatment plan can include attachment structureson only one of an upper appliance and a lower appliance.

Another particular stage in a treatment plan may not include anyattachment structures on either an upper appliance or a lower appliance.And, another particular stage in a treatment plan can include attachmentstructures on cavities corresponding to incisors, canines, premolars,and/or molars, and/or any combination thereof.

For instance, the first appliance and second appliance can be designedto receive teeth of a first jaw (e.g., an upper jaw) and interface witha first attachment structure. A third appliance of the set of appliancescan comprise a third shell having a plurality of cavities thereindesigned to received teeth of a second jaw (e.g., a lower jaw) of thepatient during a first stage of the treatment plan.

A second attachment structure designed to be attached to at least onetooth of the second jaw can include a plurality of surfaces. The thirdshell can be designed to interface with a first surface or a firstsubset of surfaces of the plurality of surfaces of the second attachmentstructure to provide a third engagement force specific to the firststage of the treatment plan.

A number of embodiments of the present disclosure include instructionsthat are executable by a processor (e.g., software), which can be fixedin a non-transitory computing device readable medium, to model apatient's jaws (e.g., including teeth, roots, gingiva, and/or supportingstructure, etc.). The instructions can be executed to create and/ormodify a treatment plan to incrementally adjust the patient's teethand/or bite, among other adjustments, via application of a series ofappliances as described herein. The instructions can be executed toprovide modified models of the patient's jaws 122 for each of thevarious stages of the treatment plan for fabrication (e.g., via rapidprototyping such as stereolithography) of physical models correspondingto the virtual models. The physical models can be used for thefabrication (e.g., via thermoforming) of appliances thereover.

According to a number of embodiments of the present disclosure, theinstructions can be executed to position an attachment structure 126 ona corresponding one or more virtual teeth 124 of a virtual model of ajaw 122. The instructions can be executed to activate a first subset ofa plurality of surfaces 128-1 . . . 128-N of the attachment structure126 to provide an engagement force at a particular stage of treatmentand/or activate different subsets of surfaces 128-1 . . . 128-N of theattachment structure 126 for subsequent stages of treatment.

As discussed above, activating a surface of an attachment structure, asused herein, can include selecting the surface to interface with a shellof a particular stage of the treatment plan. The virtual model of thejaw 122 can be different at each stage of treatment according to thetreatment plan (e.g., positioning of the virtual teeth can change) andtherefore the surfaces that are activated can change from one stage oftreatment to another. The instructions can be executed to change theactivated surfaces of the attachment structure 126 according to changesto the virtual model of the jaw 122 between treatment stages and/oraccording to anticipated changes in subsequent stages of treatment(e.g., to help effectuate a desired movement of one or more virtualteeth of the virtual model of the jaw 122).

For each stage of treatment, the instructions can be executed to modelengagement forces applied to the virtual model of the jaw 122 by anappliance corresponding to that stage (to simulate actual forces to beapplied to a patient's physical jaw by a physical appliance and thephysical appliance interfacing with an attachment structure 126/tosimulate actual interference of the surfaces of the attachment structure126 with the physical appliance that produces a force). Those forces caninclude forces applied to the virtual model of the jaw 122 by virtue ofthe appliance being slightly out of alignment with a currentconfiguration of the virtual teeth and/or include inherent forcesapplied to the aligner by the patient (e.g., when the shell of theappliance interfaces with one or more surfaces of the attachmentstructure 126).

The virtual models illustrated and/or described herein (e.g., FIG. 1,etc.) can represent a stage of a treatment plan, can be used to modelforces applied to the virtual models, can be used to create a physicalmodel for formation of a physical appliance thereover, and/or can beused for direct fabrication of a physical appliance (without creating aphysical model), among other uses.

Positioning an attachment structure 126 and/or activating one or moresurfaces 128-1 . . . 128-N to interface with a shell on a virtual modelof a jaw 122 can be automatic (e.g., by operation of software based onforce modeling for a particular stage of treatment), manual (e.g., byoperation of an operator interacting with the virtual model via aninterface with a computing device), or a combination thereof. Likewise,the shape (e.g., size, orientation (e.g., various angles with respect toreferences)) and/or attachment location (on the virtual tooth 124) ofthe attachment structure 126 can be automatically set by the software,by manual operation (e.g., an operator can specify the necessarycriteria of the virtual attachment structure and/or modify defaultcriteria provided by the software), or a combination thereof.

The instructions to position the attachment structure 126 and/oractivate one or more surfaces 128-1 . . . 128-N can incorporate a resultof instructions to model forces used to reposition virtual teeth. Forexample, the instructions can be executed to model a first number offorces used to reposition a corresponding at least one virtual tooth afirst distance according to a first stage (“first” indicating anarbitrary stage, not necessarily an original stage) of a treatment planand the instructions can be executed to incorporate a result of modelingthe first number of forces in order to position the attachment structure126 and/or activate a first subset of the plurality of surfaces 128-1 .. . 128-N to interface with a first shell to provide a first engagementforce corresponding to a first stage of the treatment plan. Theinstructions executed to activate a second subset of the surfaces 128-1. . . 128-N can incorporate a result of instructions executed to model asecond number of forces used to reposition the at least one virtualtooth a second distance according to a second stage of the treatmentplan (e.g., a stage subsequent to the first stage, but not necessarilysequential thereto).

According to a number of embodiments of the present disclosure, theactivated one or more surfaces 128-1 . . . 128-N can be specific to aparticular stage of treatment. The activated surfaces 128-1 . . . 128-Nfor subsequent stages of treatment can change from the activatedsurfaces for the particular stage based on the particular forces to movethe one or more teeth in the subsequent stages (e.g., to help effectuatea desired change to the virtual model of the jaw 122).

More accurate modeling of the force applied by the one or more surfaces128-1 . . . 128-N of the attachment structure 126 interfacing with theshell of the dental appliance can lead to more favorable results fromthe treatment plan for the patient (e.g., the actual results can moreaccurately reflect the modeled results in the treatment plan).

Various stages of a treatment plan can include or not include anappliance to cover the teeth of the opposing jaw and different stages ofthe treatment plan can include or not include activated surfaces 128-1 .. . 128-N of the attachment structure 126. For example, a particularstage of a treatment plan can include an appliance over each of theupper jaw and lower jaw of a patient, where one of the appliancesincludes shapes designed to interface with the activated surfaces 128-1. . . 128-N of the attachment structure 126, and where the attachmentstructure 126 is designed to interface with the particular appliance toprovide an engagement force specific to a stage of the treatment plan.

A number of appliances in a series of appliances created as part of atreatment plan can perform different functions. Some of the functionsperformed by different appliances in the series may overlap and some maybe unique to a particular appliance. By way of example, a firstappliance can interface with a first subset of surfaces 128-1 . . .128-N of an attachment structure 126 designed to provide a firstengagement force to a tooth 124 of a first jaw and/or a second jaw tomove the tooth 124 a first distance specific to a first stage of thetreatment plan. A second appliance can interface with a second subset ofsurfaces 128-1 . . . 128-N of the attachment structure 126 designed toprovide a second engagement force to the tooth 124 of a first jaw and/ora second jaw to move the tooth 124 a second distance specific to asecond stage of the treatment plan. A third appliance may, for instance,minimize (e.g., avoid) and/or not interface with surfaces 128-1 . . .128-N of the attachment structure 126.

FIG. 2A illustrates an example of an attachment structure 226 accordingto one or more embodiments of the present disclosure. The attachmentstructure 226 can include a body structure designed to be attached to atleast one tooth of a jaw of a patient and a plurality of surfaces 228-1,228-2, 228-3, 228-4, 228-5 . . . 228-N (herein generally referred to as“the surfaces 228”). The body structure, in some embodiments, caninclude a geometric shape. Example geometric shapes can include acircle, oval, rectangle, hexagon, etc.

The surfaces 228 can be oriented about the body structure. For instance,the surfaces 228 can be oriented normal to one another about the bodystructure and designed to be separately activated in a variety oforientations (e.g., to provide a variety of engagement forces). Normalto one another, as used herein, can include a surface that isperpendicular to a tangent vector of the curve of the attachmentstructure 226. The surfaces 228 can include, for instance, at leastthree surfaces. In various embodiments, as illustrated by FIG. 2A, thesurfaces 228 can include six surfaces. Although embodiments inaccordance with the present disclosure are not so limited and caninclude variety of number of surfaces.

The surfaces 228, as illustrated by the embodiment of FIG. 2A, can beformed by portions of the attachment structure 226 having a first height231 and portions of the attachment structure 226 having a second height229, wherein the second height 229 is greater than the first height 231.That is, portions of the attachment structure 226 can have a greaterheight than other portions. The surfaces 228 can be the edges of theportions of the attachment structure 226 having the second height 229(e.g., the edges of the portions of the attachment structure that areraised).

In some embodiments, the edges can be perpendicular to one or both ofthe portions of the attachment structure having a first height 231 andsecond height 229. In some embodiments, the angle of the edge can begreater or less than perpendicular.

For example, one attachment structure embodiment can include a bodystructure designed to be attached to at least one tooth of a jaw, atleast three surfaces about the body structure, wherein the at leastthree surfaces are oriented normal to one another about the bodystructure and designed to be separately selected in a variety oforientations, and wherein the attachment structure is designed tointerface with a first appliance of a series of appliances designed toincrementally implement a treatment plan to provide a first engagementforce specific to a first stage of the treatment plan and designed tointerface with a second appliance of the series to provide a secondengagement force specific to a second stage of the treatment plan, andwherein the first engagement force and the second engagement forceinclude different forces.

FIG. 2B illustrates an example of a plurality of attachment structurecomponents 227-1, 227-2 . . . 227-P according to one or more embodimentsof the present disclosure. In some embodiments, the attachment structure226, as illustrated in the embodiment of FIG. 2B, can include aplurality of attachment structure components 227-1, 227-2 . . . 227-P(herein generally referred to as “the attachment structure components227”) each individually designed to be attached to at least one tooth ofa jaw of a patient.

The attachment structure 226 can include a plurality of surfaces 228-1,228-2, 228-3, 228-4, 228-5 . . . 228-N (herein generally referred to as“the surfaces 228”). Each of the attachment structure components 227can, for example, include one or more of the surfaces 228. For instance,the surfaces 228 can be oriented normal to one another about thegeometric shape formed by the plurality of attachment structurecomponents 227. The surfaces 228 can include, for instance, at leastthree surfaces. In various embodiments, as illustrated by FIG. 2A, thesurfaces 228 can include six surfaces. In such embodiments, the surfaces228 of the attachment structure 226 can include the edges of each of theattachment structure components 227.

Each of the plurality of attachment structure components 227, asillustrated by the embodiment of FIG. 2B, include a first height 231 anda second height 229, wherein the second height 229 is greater than thefirst height 231. The surfaces 228 can be the edges of the portions ofthe attachment structure components 227 having the second height 229(e.g., the edges of the portions of the attachment structure that areraised).

FIG. 2C illustrates an example of an attachment structure 226 accordingto one or more embodiments of the present disclosure. As discussedabove, the attachment structure 226 can include a body structuredesigned to be attached to at least one tooth of a jaw of a patient anda plurality of surfaces 228-1, 228-2, 228-3, 228-4, 228-5 . . . 228-N(herein generally referred to as “the surfaces 228”).

As illustrated by the embodiment of FIG. 2C, in various examples, thesurfaces 228 can be oriented about the body structure at a variety ofdistances. That is, the distance of portions of the attachment structure226 at a first height and a second height can also be varying distances.

FIG. 3 illustrates a system for treatment planning according to one ormore embodiments of the present disclosure. In the system illustrated inFIG. 3, the system includes a computing device 327 having a number ofcomponents coupled thereto. The computing device 327 includes aprocessor 325 and memory 329. The memory 329 can include various typesof information including data 330 and executable instructions 332 asdiscussed herein.

Memory and/or the processor may be located on the computing device 327or off the device in some embodiments. As such, as illustrated in theembodiment of FIG. 3, a system can include a network interface 334. Suchan interface can allow for processing on another networked computingdevice or such devices can be used to obtain information about thepatient or executable instructions for use with various embodimentsprovided herein.

As illustrated in the embodiment of FIG. 3, a system can include one ormore input and/or output interfaces 336. Such interfaces can be used toconnect the computing device with one or more input or output devices.

For example, in the embodiment illustrated in FIG. 3, the systemincludes connectivity to a scanning device 340, a camera dock 342, aninput device 344 (e.g., a keyboard, mouse, etc.), a display device 346(e.g., a monitor), and a printer 348. The processor 325 can beconfigured to provide a visual indication of a virtual model on thedisplay 346 (e.g., on a GUI running on the processor 325 and visible onthe display 346). The input/output interface 336 can receive data,storable in the data storage device (e.g., memory 328), representing thevirtual model (e.g., corresponding to the patient's upper jaw and thepatient's lower jaw).

In some embodiments, the scanning device 340 can be configured to scan aphysical mold of a patient's upper jaw and a physical mold of apatient's lower jaw. In one or more embodiments, the scanning device 340can be configured to scan the patient's upper and/or lower jaws directly(e.g., intraorally).

The camera dock 342 can receive an input from an imaging device (e.g., a2D imaging device) such as a digital camera or a printed photographscanner. The input from the imaging device can be stored in the memory329.

Such connectivity can allow for the input and/or output of virtual modelinformation or instructions (e.g., input via keyboard) among other typesof information. Although some embodiments may be distributed amongvarious computing devices within one or more networks, such systems asillustrated in FIG. 3 can be beneficial in allowing for the capture,calculation, and/or analysis of information discussed herein.

The processor 325, in association with the memory 329, can be associatedwith data and/or application modules. The processor 325, in associationwith the memory 329, can store and/or utilize data and/or executeinstructions to provide treatment planning that includes an attachmentstructure.

Such data can include the virtual model described herein (e.g.,including a first jaw, a second jaw, a number of appliances, etc.). Suchexecutable instructions can include instructions for attachmentstructure design and/or placement, force calculation, engagement forcecalculation, and/or treatment planning, among other functions.

Instructions for attachment structure design and/or placement can beconfigured to position an attachment structure on at least one virtualtooth of a virtual model of a jaw. The attachment structure instructionscan be configured to incorporate a result of a number of forces modeledby the force calculation instructions (e.g., forces used to repositionthe corresponding at least one virtual tooth a first distance accordingto a first stage of the treatment plan).

For example, in response to a determination that at least one of thenumber of forces used to reposition the corresponding at least onevirtual tooth the first distance is greater than a force a physicalappliance can physically apply to the physical tooth, an attachmentstructure can be positioned on the at least one virtual tooth. As anexample, the amount of surface area of the tooth perpendicular to a lineof movement (e.g., a vector to move the tooth the first distance) may beinsufficient for the appliance to deliver the necessary force.

Alternatively and/or in addition, one of the number of forces (and/orone of the engagement forces calculated, as discussed further herein)can include and/or cause an undesirable or unwanted force on the atleast one virtual tooth. Such a force can include, for instance, a forcebeyond a threshold force and/or a force that tips a tooth beyond athreshold, among other forces.

The attachment structure instructions can be configured to activate afirst subset of the plurality of surfaces of the attachment structure ata first stage of a treatment plan that is incremented in stages. Forinstance, the attachment structure instructions can be configured toincorporate a result of instructions to model a first number of forcesused to reposition the corresponding at least one virtual tooth a firstdistance according to the first stage of the treatment plan to activatethe first subset of the plurality of surfaces.

The attachment structure instructions can be configured to activate asecond subset of the plurality of surfaces of the attachment structureat a second stage of the treatment plan according to changes to thevirtual model of the jaw between the first stage of the treatment planand the second stage of the treatment plan. For example, the attachmentstructure instructions can be configured to incorporate a result ofinstructions to model a second number of forces used to reposition thecorresponding at least one virtual tooth a second distance according tothe second stage of the treatment plan (e.g., forces used to repositionthe corresponding virtual tooth a second distance according to a secondstage of the treatment plan).

Activating a surface, as previously discussed, can include selecting thesurface to interface with a shell corresponding to a particular stage ofthe treatment plan. For instance, activating a surface can includechanging a characteristic of the virtual model of the attachmentstructure.

As an example, an initial virtual attachment structure attached to thetooth can include the attachment structure and/or a plurality ofattachment structure components that have a first height (e.g., asillustrated by the attachment structure 126 of FIG. 1, wherein theportions of the attachment structure are a first height/flat). Inresponse to determining to activate a surface, a portion of the virtualattachment structure can be changed to a second height.

The first height can include a lower height than the second height.Thereby, changing the portion of the virtual attachment structure to asecond height can create the virtual activated surface. The shape of thecavity of the shell (e.g., virtual model of the shell and/or thephysical device to be formed from the virtual model) designed tointerface with the activated surface can, for instance, be slightly outof alignment with the current configuration of the particular tooth tointerface with the one or more surfaces of the attachment structure andto provide the particular engagement force.

Alternatively, an initial virtual attachment structure can have portionsof a first height and portions of a second height (e.g., as illustratedby the attachment structures 226 illustrated in FIGS. 2A-2B). Inresponse to determining to activate a surface, a portion of theattachment structure of the second height proximal to the activatedsurface can have a length changed from a first length to a second lengthproximal to the activated surface.

The second length can include a smaller length than the first length. Alength of a portion of the attachment structure, as used herein, caninclude a distance about the attachment structure. Thereby, the lengthof the portion of the virtual attachment structure (and/or a physicalmold) can include a smaller length than the physical length of theportion of the physical attachment structure designed to be attached toa tooth. The shape of the cavity of the shell (e.g., virtual model ofthe shell and/or the physical device to be formed from the virtualmodel) designed to interface with the activated surface can, forinstance, include additional material designed to interface with the oneor more surfaces of the attachment structure and to provide theparticular engagement force.

The force calculation instructions can be configured to model one ormore forces used to reposition one or more teeth a distance according toa treatment plan. For instance, the force calculation instructions canmodel a first number of forces used to reposition at least one virtualtooth a first distance according to a first stage of the treatment planand a second number of forces used to reposition at least one virtualtooth a second distance according to a second stage of the treatmentplan. The treatment plan instructions can be configured to create, edit,delete, revise, or otherwise modify the treatment plan (e.g., based atleast in part on operation of other application instructions).

The engagement force instructions can be configured to model engagementforces to be applied to one or more teeth of a patient by wearing acorresponding appliance (e.g., with shape designed to interface with theactivated surfaces of the respective stage of the treatment plan).Modeling an engagement force can include, for example, modeling aninterference between the activated surfaces and the appliance thatproduces a force. For example, the engagement force instructions canmodel a first engagement force to be applied by a first subset of theplurality of surfaces of the attachment structure interfacing with acorresponding one of the appliances during the first stage of thetreatment plan and model a second engagement force to be applied by asecond subset of the plurality of surfaces of the attachment structureinterfacing with a corresponding one of the appliances during the secondstage of the treatment plan.

In some embodiments, the attachment structure instructions and/or thetreatment plan instructions can revise a shape, location, and/ororientation of the attachment structure based on at least one of themodeled first engagement force and the modeled second engagement force.For instance, the modeled engagement forces may identify a force on atooth and/or an appliance that is above a threshold, inadequate to movethe tooth the particular distance, and/or includes an unwanted and/orundesirable force, among other forces.

In various embodiments, a generalized engagement force can be modeledbased on testing in a lab. For example, during development of theattachment structure, a physical mold of teeth can be used to testgeneralized engagement forces applied by a physical attachment structureinterfacing with a physical appliance. Attachment structures,positioning of the attachment structures, and/or activated surfaces canbe revised and physically tested to determine a number of generalizedengagement forces. The generalized engagement forces can be input asattachment structure instructions and/or the treatment plan instructionsto assist in modeling engagement forces to be applied by the attachmentstructure and the activated surfaces interfacing for a number ofpatients when a treatment is applied.

The virtual model can be provided (e.g., via network interface 334) forfabrication of physical models corresponding to the jaw at the first andthe second stages of the treatment plan for formation of appliancesthereover such that the appliances includes a shape designed tointerface with the activated surfaces of the attachment structure. Forinstance, an appliance that includes the shape designed to interfacewith the activated surfaces can include a surface on the shell of theappliance designed to interface with the activated surfaces (e.g., a lipsimilar to that discussed with respect to FIG. 1).

FIG. 4 illustrates an example process 450 for treatment planningaccording to one or more embodiments of the present disclosure. At block452, the process 450 can include modeling a number of forces to apply tomove one or more teeth a distance specific to a stage of a treatmentplan. At block 454, a determination is made whether a physical appliancecan apply the number of forces.

In response to determining the appliance is able to apply the number offorces, at block 456, a determination is made as to whether the numberof forces include an unwanted and/or undesirable force. In response todetermining the number of forces do not include an unwanted and/orundesirable force, the process can be complete at block 468 (e.g., avirtual model of the appliance, virtual model of a jaw, a physical modelof the jaw, and/or a physical appliance can be created). As used herein,a virtual model is a computing device generated version of a physicaldental appliance and/or attachment that can be viewed by a computingdevice display and/or be used to fabricate a physical dental applianceand/or attachment.

In response to determining that the appliance is unable to apply atleast one of the number of modeled forces (e.g., from block 454) and/ordetermining the number of forces include an unwanted and/or undesirableforce (e.g., from block 456), the process 450, at block 458, can includeadding an attachment structure to a virtual model of one or more teeth.The attachment structure can include a plurality of surfaces.

One or more of the surfaces can be activated based on the number ofmodeled forces. For instance, the one or more surfaces can be activatedto allow the appliance to apply the number of forces, and/or to preventand/or minimize an unwanted and/or undesirable force.

At block 460, an engagement force to be applied by the one or moreactivated surfaces of the attachment structure interfacing with acorresponding appliance during a stage of the treatment plan can becalculated (e.g., modeled). The corresponding appliance can include ashape designed to interface with the activated surfaces. Thereby, thecalculated engagement force can include a number of forces applied tothe one or more virtual teeth of the patient and/or the appliance (e.g.,an interference) when the appliance and the attachment structureinterface.

At block 462, a determination can be made whether the engagement forceis adequate. For instance, the engagement force can be compared to themodeled number of forces to apply to move one or more teeth a distancespecific to a stage of a treatment plan.

In response to identifying the engagement force is above a thresholdforce (e.g., above a maximum force to apply to a tooth and/or anappliance), insufficient to move the one or more teeth the distance(e.g., is less than one or more of the number of forces), and/orincludes an unwanted and/or undesirable force, at block 464, theattachment structure can be revised. For instance, revising theattachment structure can include revising activated surfaces, a shape, alocation, and/or an orientation on the structure and/or changing theinstructions provided to the treatment professional regarding thepositioning of the attachment on the tooth (move the attachment up ordown on the tooth and/or rotate the attachment to change the angle ofthe surfaces with respect to the appliance), among other revisions, ofthe attachment structure.

The revised attachment structure can be added to the one or more virtualteeth (e.g., block 458), a new engagement force can be calculate (e.g.,at block 460), the new engagement force calculated can be compared tothe modeled number of forces, a threshold force, and/or unwanted and/orundesirable forces (e.g., at block 462) and such adjustments can beiteratively done until a most suitable implementation is identified, bya treatment professional and/or a computing device, for example, throughcomparison of the force analyses done in these iterations. In responseto identifying that the engagement force (and/or new engagement force)is an adequate force, at block 468, the process 450 can finish.

FIG. 5A-5C illustrate examples of a jaw 596 including an attachmentstructure 526 attached to a tooth 585 and a series of appliances 587,589according to one or more embodiments of the present disclosure. The jaw596 can include a physical jaw and/or a virtual model of a jaw. Forinstance, the jaw 596 can include a set of teeth of the jaw of thepatient, including the tooth 585. The attachment structure 526 caninclude a virtual model (e.g., a virtual attachment structure) of aphysical attachment structure and/or a physical attachment structure.

The attachment structure 526, as illustrated by FIGS. 5A-5C, can includea geometric shape with a plurality of surfaces 528-1, 528-2, 528-3,528-4, 528-5, 528-6. The attachment structure 526 can be designed to beattached to a tooth 585 of a patient. Alternatively, in someembodiments, an attachment structure can include a plurality ofattachment structure components (as illustrated by FIG. 2B).

With respect to the example of FIGS. 5A-5C, one or more appliances 587,589 can be designed to interface with at least one surface of theattachment structure 526. For instance, an appliance can be designed tointerface with a subset of the plurality of surfaces 528-1 . . . 528-6.The attachment structure 526 can be designed to be attached to the tooth585 of the patient at one stage of the treatment plan and subsequentlyused at another stage of the treatment plan to provide one or moreengagement forces to the tooth 585 without removal or adjustment of theattachment structure 526. For example, the surfaces 528-1 . . . 528-6 ofthe attachment structure 526 can be oriented about the attachmentstructure 526 such that a variety of combinations of the surfaces 528-1. . . 528-6 can provide a variety of engagement forces.

The appliances 587, 589 illustrated by FIGS. 5A-5C can include and/or bepart of a series of appliances. A series of appliances according to thepresent disclosure can include a plurality of incremental dentalposition adjustment appliances. The appliances can be utilized toincrementally implement a treatment plan such as by affectingincremental repositioning of individual teeth in the jaw, among othersuitable uses.

For example, FIGS. 5A-5B illustrate a first appliance 587 of a series ofappliances. A first appliance 587 of the series can be designed to fitover teeth in a jaw of a patient and can comprise a first shell having aplurality of cavities designed to receive teeth of the jaw of thepatient. The first shell can be designed to interface with one or moresurfaces of the attachment structure 526 and/or the teeth of thepatient's jaw. The one or more surfaces that interface with the firstshell can be specific to a stage of a treatment plan for which the firstappliance 587 was designed.

For example, successive appliances created according to a treatment planmay include a shape designed to interface with one or more activatedsurfaces 528-1 . . . 528-6. The one or more surfaces can be activated,as previously discussed herein, according to a model of a number offorces used to reposition the at least one tooth 585 a distanceaccording to a stage of the treatment plan.

FIG. 5C includes an illustration of a second appliance 589 of theseries. A second appliance 589 of the series can comprise a second shellhaving a plurality of cavities therein designed to receive teeth of thejaw of the patient (e.g., the same jaw that the first appliance 587illustrated by FIG. 5A-5B is designed to receive). The second shell canbe designed to interface with a second surface or a second subset of theplurality of surfaces 528-1 . . . 528-6 of the attachment structure 526to provide a second engagement force specific to a subsequent stage(e.g., second stage) of the treatment plan.

For example, the first appliance 587 can be placed over the jaw 596 ofthe patient and can be designed to interface with a first subset 528-2,528-5 of surfaces 528-1 . . . 528-6 of the attachment structure 526. Theinterface can provide a first engagement force to move the at least onetooth 585 toward a first position that is specific to the first stage ofthe treatment plan and/or to minimize or prevent movement of and/orforces on the at least one tooth 585.

For example, the first engagement force can include a combination offorces 581, 583 (e.g., directional forces) provided by the first subset528-2, 528-5 of surfaces 528-1 . . . 528-6 interfacing with the firstappliance 587 (e.g., as illustrated by the direction of the arrows 581,583). The first appliance 587 can include, for instance, one or moreshapes 594-1, 594-2 designed to interface with the first subset 528-2,528-5 of surfaces 528-1 . . . 528-6 (e.g., activated surfaces) when thefirst appliance 587 is worn over the jaw 596 by the patient.

FIG. 5B includes an illustration of the first appliance 587 when wornover the jaw of the patient. The attachment structure 526 attached tothe tooth 585 can interface with the first appliance 587 to provide thefirst engagement force. For instance, the first appliance 587 caninclude a first shape 594-1 and a second shape 594-2. The shapes 594-1,594-2 can interface with a first subset of surfaces (e.g., surfaces528-2, 528-5 illustrated by FIG. 5A) to provide the first engagementforce (e.g., the combination of forces 581, 583 illustrated by FIG. 5A),for example.

FIG. 5C includes an illustration of the second appliance 589 in theseries of appliances 587, 589. The attachment structure 526, asillustrated by FIG. 5C, is attached to the same tooth 585 of the samejaw 596 as illustrated in FIG. 5A.

The second appliance 589 can be placed over the jaw 596 of the patientand can be designed to interface with a second subset 528-1, 528-3,528-5 of surfaces 528-1 . . . 528-6 of the attachment structure 526. Theinterface can provide a second engagement force to move the at least onetooth 596 toward a second position that is specific to the second stageof the treatment plan and/or to minimize or prevent movement of and/orforces on the at least one tooth 585.

For instance, the second engagement force can include a combination offorces 591, 592, 593 (e.g., directional forces) provided by the secondsubset 528-1, 528-3, 528-5 of the surfaces 528-1 . . . 528-6 interfacingwith the second appliance 589 (e.g., as illustrated by the direction ofthe arrows 591, 592, 593). For example, the second appliance 589 (e.g.,second shell) can include one or more shapes 594-1, 594-2, 594-3designed to interface with the second subset 528-1, 528-3, 528-5 of thesurfaces 528-1 . . . 528-6 (e.g., activated surfaces) when the secondappliance 589 is worn over the jaw 596 by the patient. In this manner,the attachment structure 526 can be used with multiple appliances (e.g.,first appliance 587 and second appliance 589) to provide multipleengagement forces.

Although specific embodiments have been illustrated and describedherein, those of ordinary skill in the art will appreciate that anyarrangement calculated to achieve the same techniques can be substitutedfor the specific embodiments shown. This disclosure is intended to coverany and all adaptations or variations of various embodiments of thedisclosure.

It is to be understood that the use of the terms “a”, “an”, “one ormore”, “a number of”, or “at least one” are all to be interpreted asmeaning one or more of an item is present. Additionally, it is to beunderstood that the above description has been made in an illustrativefashion, and not a restrictive one. Combination of the aboveembodiments, and other embodiments not specifically described hereinwill be apparent to those of skill in the art upon reviewing the abovedescription.

It will be understood that when an element is referred to as being “on,”“connected to” or “coupled with” another element, it can be directly on,connected, or coupled with the other element or intervening elements maybe present. In contrast, when an element is referred to as being“directly on,” “directly connected to” or “directly coupled with”another element, there are no intervening elements or layers present. Asused herein, the term “and/or” includes any and all combinations of oneor more of the associated listed items.

It will be understood that, although the terms first, second, etc. maybe used herein to describe various elements and that these elementsshould not be limited by these terms. These terms are only used todistinguish one element from another element. Thus, a first elementcould be termed a second element without departing from the teachings ofthe present disclosure.

The scope of the various embodiments of the disclosure includes anyother applications in which the above structures and methods are used.Therefore, the scope of various embodiments of the disclosure should bedetermined with reference to the appended claims, along with the fullrange of equivalents to which such claims are entitled.

In the foregoing Detailed Description, various features are groupedtogether in a single embodiment for the purpose of streamlining thedisclosure. This method of disclosure is not to be interpreted asreflecting an intention that the embodiments of the disclosure requiremore features than are expressly recited in each claim.

Rather, as the following claims reflect, inventive subject matter liesin less than all features of a single disclosed embodiment. Thus, thefollowing claims are hereby incorporated into the Detailed Description,with each claim standing on its own as a separate embodiment.

What is claimed is:
 1. A method of forming an appliance system formoving a patient's teeth according to an orthodontic treatment plan, themethod comprising: forming a virtual attachment structure on a tooth ofa virtual model of the patient's teeth, the virtual attachment structurecomprising: an annular-shaped base coupled to a surface of the tooth;and a raised structures extending from the annular-shaped base, each ofthe raised structures having sides that extend a height above theannular-shaped base; and forming a plurality of virtual orthodonticappliances for moving the patient's teeth through a series ofarrangements according to the orthodontic treatment plan, the pluralityof virtual orthodontic appliances including a first virtual aligner anda second virtual aligner, wherein the first virtual aligner provides afirst force on the sides of the raised structures of the virtualattachment structure according to a first stage of the orthodontictreatment plan, and the second virtual aligner provides a second forceon the sides of the raised structures of the virtual attachmentstructure according to a second stage of the orthodontic treatment plan.2. The method of claim 1, further comprising fabricating an attachmentstructure corresponding to the virtual attachment structure, andfabricating first and second aligners corresponding to the first andsecond virtual aligners.